I
119THCONGRESS
1
STSESSION H. R. 1520
To prohibit discrimination on the basis of mental or physical disability in
cases of organ transplants.
IN THE HOUSE OF REPRESENTATIVES
FEBRUARY24, 2025
Mrs. C
AMMACK(for herself, Mrs. DINGELL, Mr. ISSA, Ms. WASSERMAN
S
CHULTZ, and Mr. SESSIONS) introduced the following bill; which was re-
ferred to the Committee on Energy and Commerce
A BILL
To prohibit discrimination on the basis of mental or physical
disability in cases of organ transplants.
Be it enacted by the Senate and House of Representa-1
tives of the United States of America in Congress assembled, 2
SECTION 1. SHORT TITLE. 3
This Act may be cited as the ‘‘Charlotte Woodward 4
Organ Transplant Discrimination Prevention Act’’. 5
SEC. 2. DEFINITIONS. 6
In this Act: 7
(1) A
UXILIARY AIDS AND SERVICES .—The term 8
‘‘auxiliary aids and services’’ has the meaning given 9
VerDate Sep 11 2014 02:08 Mar 13, 2025 Jkt 059200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H1520.IH H1520
kjohnson on DSK7ZCZBW3PROD with $$_JOB 2
•HR 1520 IH
the term in section 4 of the Americans with Disabil-1
ities Act of 1990 (42 U.S.C. 12103). 2
(2) C
OVERED ENTITY.—The term ‘‘covered en-3
tity’’ means any licensed provider of health care 4
services (including licensed health care practitioners, 5
hospitals, nursing facilities, laboratories, inter-6
mediate care facilities, psychiatric residential treat-7
ment facilities, institutions for individuals with intel-8
lectual or developmental disabilities, and prison 9
health centers), and any transplant hospital (as de-10
fined in section 121.2 of title 42, Code of Federal 11
Regulations or a successor regulation), that— 12
(A) is in interstate commerce; or 13
(B) provides health care services in a man-14
ner that— 15
(i) substantially affects or has a sub-16
stantial relation to interstate commerce; or 17
(ii) includes use of an instrument (in-18
cluding an instrument of transportation or 19
communication) of interstate commerce. 20
(3) D
ISABILITY.—The term ‘‘disability’’ has the 21
meaning given the term in section 3 of the Ameri-22
cans with Disabilities Act of 1990 (42 U.S.C. 23
12102). 24
VerDate Sep 11 2014 02:08 Mar 13, 2025 Jkt 059200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H1520.IH H1520
kjohnson on DSK7ZCZBW3PROD with $$_JOB 3
•HR 1520 IH
(4) HUMAN ORGAN.—The term ‘‘human organ’’ 1
has the meaning given the term in section 301(c) of 2
the National Organ Transplant Act (42 U.S.C. 3
274e(c)). 4
(5) O
RGAN TRANSPLANT .—The term ‘‘organ 5
transplant’’ means the transplantation or trans-6
fusion of a donated human organ into the body of 7
another human for the purpose of treating a medical 8
condition. 9
(6) Q
UALIFIED INDIVIDUAL.—The term ‘‘quali-10
fied individual’’ means an individual who, with or 11
without a support network, provision of auxiliary 12
aids and services, or reasonable modifications to 13
policies or practices, meets eligibility requirements 14
for the receipt of a human organ. 15
(7) R
EASONABLE MODIFICATIONS TO POLICIES 16
OR PRACTICES.—The term ‘‘reasonable modifications 17
to policies or practices’’ includes— 18
(A) communication with persons respon-19
sible for supporting a qualified individual with 20
postsurgical or other care following an organ 21
transplant or related services, including support 22
with medication; 23
(B) consideration, in determining whether 24
a qualified individual will be able to comply 25
VerDate Sep 11 2014 02:08 Mar 13, 2025 Jkt 059200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H1520.IH H1520
kjohnson on DSK7ZCZBW3PROD with $$_JOB 4
•HR 1520 IH
with health requirements following an organ 1
transplant or receipt of related services, of sup-2
port networks available to the qualified indi-3
vidual, including family, friends, and providers 4
of home and community-based services, includ-5
ing home and community-based services funded 6
through the Medicare or Medicaid program 7
under title XVIII or XIX, respectively, of the 8
Social Security Act (42 U.S.C. 1395 et seq., 9
1396 et seq.), another health plan in which the 10
qualified individual is enrolled, or any program 11
or source of funding available to the qualified 12
individual; and 13
(C) the use of supported decision-making, 14
when needed, by a qualified individual. 15
(8) R
ELATED SERVICES.—The term ‘‘related 16
services’’ means services related to an organ trans-17
plant that consist of— 18
(A) evaluation; 19
(B) counseling; 20
(C) treatment, including postoperative 21
treatment, and care; 22
(D) provision of information; and 23
(E) any other service recommended or re-24
quired by a physician. 25
VerDate Sep 11 2014 02:08 Mar 13, 2025 Jkt 059200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H1520.IH H1520
kjohnson on DSK7ZCZBW3PROD with $$_JOB 5
•HR 1520 IH
(9) SUPPORTED DECISION -MAKING.—The term 1
‘‘supported decision-making’’ means the use of a 2
support person to assist a qualified individual in 3
making health care decisions, communicate informa-4
tion to the qualified individual, or ascertain a quali-5
fied individual’s wishes. Such term includes— 6
(A) the inclusion of the individual’s attor-7
ney-in-fact or health care proxy, or any person 8
of the individual’s choice, in communications 9
about the individual’s health care; 10
(B) permitting the individual to designate 11
a person of the individual’s choice for the pur-12
poses of supporting that individual in commu-13
nicating, processing information, or making 14
health care decisions; 15
(C) providing auxiliary aids and services to 16
facilitate the individual’s ability to communicate 17
and process health-related information, includ-18
ing providing use of assistive communication 19
technology; 20
(D) providing health information to per-21
sons designated by the individual, consistent 22
with the regulations promulgated under section 23
264(c) of the Health Insurance Portability and 24
Accountability Act of 1996 (42 U.S.C. 1320d– 25
VerDate Sep 11 2014 02:08 Mar 13, 2025 Jkt 059200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H1520.IH H1520
kjohnson on DSK7ZCZBW3PROD with $$_JOB 6
•HR 1520 IH
2 note) and other applicable laws and regula-1
tions governing disclosure of health informa-2
tion; 3
(E) providing health information in a for-4
mat that is readily understandable by the indi-5
vidual; and 6
(F) working with a court-appointed guard-7
ian or other person responsible for making 8
health care decisions on behalf of the individual, 9
to ensure that the individual is included in deci-10
sions involving the health care of the individual 11
and that health care decisions are in accordance 12
with the individual’s own expressed interests. 13
(10) S
UPPORT NETWORK .—The term ‘‘support 14
network’’ means, with respect to a qualified indi-15
vidual, 1 or more people who are— 16
(A) selected by the qualified individual or 17
by the qualified individual and the guardian of 18
the qualified individual, to provide assistance to 19
the qualified individual or guidance to that 20
qualified individual in understanding issues, 21
making plans for the future, or making complex 22
decisions; and 23
(B) who may include the family members, 24
friends, unpaid supporters, members of the reli-25
VerDate Sep 11 2014 02:08 Mar 13, 2025 Jkt 059200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H1520.IH H1520
kjohnson on DSK7ZCZBW3PROD with $$_JOB 7
•HR 1520 IH
gious congregation, and appropriate personnel 1
at a community center, of or serving the quali-2
fied individual. 3
SEC. 3. PROHIBITION OF DISCRIMINATORY POLICY. 4
The board of directors described in section 5
372(b)(1)(B) of the Public Health Service Act (42 U.S.C. 6
274(b)(1)(B)) shall not issue policies, recommendations, 7
or other memoranda that would prohibit, or otherwise 8
hinder, a qualified individual’s access to an organ trans-9
plant solely on the basis of that individual’s disability. 10
SEC. 4. PROHIBITION OF DISCRIMINATION. 11
(a) I
NGENERAL.—Subject to subsection (b), a cov-12
ered entity may not, solely on the basis of a qualified indi-13
vidual’s disability— 14
(1) determine that the individual is ineligible to 15
receive an organ transplant or related services; 16
(2) deny the individual an organ transplant or 17
related services; 18
(3) refuse to refer the individual to an organ 19
transplant center or other related specialist for the 20
purpose of receipt of an organ transplant or other 21
related services; or 22
(4) refuse to place the individual on an organ 23
transplant waiting list. 24
(b) E
XCEPTION.— 25
VerDate Sep 11 2014 02:08 Mar 13, 2025 Jkt 059200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H1520.IH H1520
kjohnson on DSK7ZCZBW3PROD with $$_JOB 8
•HR 1520 IH
(1) IN GENERAL.— 1
(A) M
EDICALLY SIGNIFICANT DISABIL -2
ITIES.—Notwithstanding subsection (a), a cov-3
ered entity may take a qualified individual’s 4
disability into account when making a health 5
care treatment or coverage recommendation or 6
decision, solely to the extent that the disability 7
has been found by a physician, following an in-8
dividualized evaluation of the potential recipi-9
ent, to be medically significant to the receipt of 10
the organ transplant or related services, as the 11
case may be. 12
(B) C
ONSTRUCTION.—Subparagraph (A) 13
shall not be construed to require a referral or 14
recommendation for, or the performance of, a 15
medically inappropriate organ transplant or 16
medically inappropriate related services. 17
(2) C
LARIFICATION.—If a qualified individual 18
has the necessary support network to provide a rea-19
sonable assurance that the qualified individual will 20
be able to comply with health requirements following 21
an organ transplant or receipt of related services, as 22
the case may be, the qualified individual’s inability 23
to independently comply with those requirements 24
VerDate Sep 11 2014 02:08 Mar 13, 2025 Jkt 059200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H1520.IH H1520
kjohnson on DSK7ZCZBW3PROD with $$_JOB 9
•HR 1520 IH
may not be construed to be medically significant for 1
purposes of paragraph (1). 2
(c) R
EASONABLEMODIFICATIONS.—A covered entity 3
shall make reasonable modifications to policies or practices 4
(including procedures) of such entity if such modifications 5
are necessary to make an organ transplant or related serv-6
ices available to qualified individuals with disabilities, un-7
less the entity can demonstrate that making such modi-8
fications would fundamentally alter the nature of such 9
policies or practices. 10
(d) C
LARIFICATIONS.— 11
(1) N
O DENIAL OF SERVICES BECAUSE OF AB -12
SENCE OF AUXILIARY AIDS AND SERVICES .—For 13
purposes of this section, a covered entity shall take 14
such steps as may be necessary to ensure that a 15
qualified individual with a disability is not denied a 16
procedure associated with the receipt of an organ 17
transplant or related services, because of the absence 18
of auxiliary aids and services, unless the covered en-19
tity can demonstrate that taking such steps would 20
fundamentally alter the nature of the procedure 21
being offered or would result in an undue burden on 22
the entity. 23
(2) C
OMPLIANCE WITH OTHER LAW .—Nothing 24
in this section shall be construed— 25
VerDate Sep 11 2014 02:08 Mar 13, 2025 Jkt 059200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H1520.IH H1520
kjohnson on DSK7ZCZBW3PROD with $$_JOB 10
•HR 1520 IH
(A) to prevent a covered entity from pro-1
viding organ transplants or related services at 2
a level that is greater than the level that is re-3
quired by this section; or 4
(B) to limit the rights of an individual with 5
a disability under, or to replace or limit the 6
scope of obligations imposed by, the Americans 7
with Disabilities Act of 1990 (42 U.S.C. 12101 8
et seq.) including the provisions added to such 9
Act by the ADA Amendments Act of 2008, sec-10
tion 504 of the Rehabilitation Act of 1973 (29 11
U.S.C. 794), section 1557 of the Patient Pro-12
tection and Affordable Care Act (42 U.S.C. 13
18116), or any other applicable law. 14
(e) E
NFORCEMENT.— 15
(1) I
N GENERAL.—Any individual who alleges 16
that a qualified individual was subject to a violation 17
of this section by a covered entity may bring a claim 18
regarding the allegation to the Office for Civil 19
Rights of the Department of Health and Human 20
Services, for expedited resolution, as appropriate. 21
(2) R
ULE OF CONSTRUCTION .—Nothing in this 22
subsection is intended to limit or replace available 23
remedies under the Americans with Disabilities Act 24
VerDate Sep 11 2014 02:08 Mar 13, 2025 Jkt 059200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H1520.IH H1520
kjohnson on DSK7ZCZBW3PROD with $$_JOB 11
•HR 1520 IH
of 1990 (42 U.S.C. 12101 et seq.) or any other ap-1
plicable law. 2
SEC. 5. APPLICATION TO EACH PART OF PROCESS. 3
The provisions of this Act— 4
(1) that apply to an organ transplant, also 5
apply to the evaluation and listing of a qualified in-6
dividual, and to the organ transplant and post- 7
organ-transplant treatment of such an individual; 8
and 9
(2) that apply to related services, also apply to 10
the process for receipt of related services by such an 11
individual. 12
SEC. 6. EFFECT ON OTHER LAWS. 13
Nothing in this Act shall be construed to supersede 14
any provision of any State or local law that provides great-15
er rights to qualified individuals with respect to organ 16
transplants than the rights established under this Act. 17
Æ
VerDate Sep 11 2014 02:08 Mar 13, 2025 Jkt 059200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6301 E:\BILLS\H1520.IH H1520
kjohnson on DSK7ZCZBW3PROD with $$_JOB